影响SARS患者血特异性IgG抗体产生的因素  

Influence of factors on production of IgG antibody in SARS patients

作　　者：陆海英[1] 霍娜[1] 王广发[2] 李海潮[2] 聂立功[2] 阙呈立[2] 李杰[3] 李永华[3] 高晓明[3] 赵振东[3] 庄辉[3] 徐小元[1] 

机构地区：[1]北京大学第一医院感染疾病科,北京市100034 [2]北京大学第一医院呼吸科,北京市100034 [3]北京大学医学部,北京市100083

出　　处：《世界华人消化杂志》2004年第3期723-725,共3页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.30340030~~

摘　　要：目的:了解影响SARS-Coy IgG抗体产生的因素方法:对临床诊断为SARS的104例患者的269份血清进行SARS-Cov IgG抗体的动态检测,分析病程、病情、年龄及激素治疗与抗体产生的关系. 结果:104例SARS患者血清SARS-Cov IgG抗体总阳性率为79.8%(83/104),抗体最早出现时间在病日8d,最晚32 d呈阳性反应.病程0-7 d,8-14 d,22-28 d,29-35 d,36- 42 d,43-56 d和57-63 d抗体的阳转率分别为0(0/7)、50% (21/42)、63.6%(42/62)、73.3%(44/60)、88.1%(37/42)、81% (17/21)、92.6%(25/27)和50%(2/4);抗体的滴度从0-7 d的0.14±0.05上升至43-56 d的0.69±0.10(P<0.05),但8 wk后抗体滴度开始下降.重度SARS患者抗体总阳性例数比为95.7%(22/23);普通患者为75.3%(61/81),P>0.05,其抗体阳转时间稍早于普通组(分别为19.1±6.8 d和22.0±8.4 d,P=0.886),滴度也稍高于普通组(分别为0.63±0.28 和0.50±0.25,P=0.276).抗体阳性患者平均年龄与阴性患者的相近(分别为31.4±8.3岁和32.2±9.5岁),在19-35岁和46-53岁年龄段的SARS患者在病程的3 wk和4 wk时抗体的滴度相近似.大剂量糖皮质激素治疗组患者血清抗体阳性率及滴度高于小剂量组(P<0.05). 结论:SARS患者血清SARS-Cov IgG抗体总阳性率为79.8%; 抗体阳性率及滴度随病程的延长而逐渐升高,但8 wk后呈下降趋势;血清SARS-Cov IgG抗体的产生可能不受年龄的影响,而与病情的轻重有关,大剂量激素治疗组患者的抗体滴度仍维持较高水平.AIM: To study the affecting factors on the production of antibodies in SARS patients. METHODS: In a total of 104 clinically diagnosed SARS patients, the relations among IgG antibody titer, patients age, duration and the dosage of cortiscosteroids therapy were investigated. RESULTS: Eighty-three (79.8%) patients were positive for SARS-Cov antibody. The range of time for the occurrence of the antibody was 8 to 32 days; the percentage for the occurrence of the antibody in the periods of 0-7,8-14, 22-28, 29-35, 36-42, 43-56 and 57-63 d were 0, 50% (21/42, 63.6%) 42/62, 73.3% (44/60), 88.1%(37/42), 81%(17/21), 92.6% (25/27) and 50% (2/4) respectively. The titer of antibody also increased from 0.14±0.05 in 0-7 d to 0.69±0.10 (43-56 d) and started to reduce after 8 wk. The positive percentage and titers of antibody grew when the dosage of cortiscosteroids was added. The positive percentage of antibody in severe patients and mild patients were 95.7% (22/23) and 75.3% (61/81) respectively, and the titers of antibody in the severe patients were higher than that of the mild patients (P>0.05) and the same change was also found between 19-14 age group and 46-52 age group. CONCLUSION: 79.8% of SARS patients are positive for SARS-Cov antibody. The positive percentage and the titer of antibody grow gradually while the duration prolongs, but declines after 8 wk. It is positively related to the clinical condition, but not affected by the dosage of cortiscosteroids and the age of the patient.

关 键 词：特异性IGG抗体 SARS 冠状病毒 呼吸功能障碍 甲泼尼龙 严重急性呼吸综合征 

分 类 号：R511.9[医药卫生—内科学]